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Canada is on track to lose its place among the nations that have eliminated measles, as international health officials convene this week to review that designation, which experts call a measure of a country’s overall pandemic preparedness.
In October 2024, measles cases appeared, as happens in many countries. Since then, though, the virus has spread countrywide for a year. Declining vaccination rates and increased skepticism of public health messaging since the Covid-19 pandemic have been factors, experts say.
But The New York Times found that at critical points, as measles was gaining new footholds in Canada, provincial politicians stopped public health officials from speaking out about the value of getting vaccinated. That tension between politics and health policy is playing out globally.
While Ontario is the province with the most cases, the western province of Alberta has reported an outsized number for its population — the highest concentration in the country.
Alberta’s top government doctor was stopped from speaking publicly about the problem, according to interviews. Emails obtained through a public records request show the doctor urging the government to ramp up its messaging weeks before the virus arrived.
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A few dozen cases soon swelled to more than 1,000. So far this year, Alberta has recorded nearly 2,000 cases, Canada has reported more than 5,000 and the United States nearly 1,700.
The World Health Organization considers measles eliminated until it has spread unchecked for a year. Canada is set to be the first Western country since the coronavirus pandemic to lose its elimination status, according to W.H.O. data.
The specter of Covid-19 hangs over this outbreak.
One of the pandemic’s paradoxical legacies is its effect on vaccine hesitancy. The Covid-19 vaccine reduced the severity of the disease, saving millions of lives. But it did not, as many people hoped, stop the virus’s spread. Misinformation flourished, building on anger over lockdowns and school closures.
That has left some government officials wary about how to deliver health messages, particularly in communities skeptical of vaccines. Alberta’s conservative premier, Danielle Smith, has championed personal choice, calling the unvaccinated Alberta’s “most discriminated-against group.”
Childhood vaccination rates for measles have fallen in Alberta since the pandemic. They were already below the 95 percent threshold that experts say keeps the virus from spreading.
“There’s a disproportionate impact of measles in places where there’s a deep mistrust of public health or public institutions,” Dr. Deena Hinshaw, Alberta’s former chief medical officer, said in an interview. “There’s a global trend of misinformation and disinformation that’s taken root.”
Dr. Hinshaw spoke publicly for the first time since being dismissed in 2022 by Ms. Smith, who criticized Covid-era restrictions and campaigned on overhauling the public health system. Ms. Smith’s government has put checks on health officials and amended a Bill of Rights to make explicit that a person cannot be forced to be vaccinated.
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Dr. Hinshaw’s successor, Dr. Mark Joffe, resigned last April after clashing with government officials over how to address the public about measles, according to two people with knowledge of the government response who spoke on condition of anonymity because they were not authorized to do so.
While records obtained by The Times do not show anyone restricting public statements, they indicate that before measles spread to Alberta, Dr. Joffe urged more communication. “I cannot emphasize how important it is to get this messaging out,” he wrote on Feb. 28, citing outbreaks elsewhere in Canada and Alberta’s low vaccination rates.
Officials approved written communications but not a news conference, according to the two people. The medical officer’s silence spurred local curiosity. Alberta’s health minister told reporters Dr. Joffe did not believe a public address was needed. Days later, Dr. Joffe quit.
“We needed more communication and we needed to communicate with people in ways that they would understand,” he said in an interview, declining to detail government deliberations.
After leaving government, he publicly urged people to get vaccinated.
Maddison McKee, a spokeswoman for Alberta’s health minister, did not address Dr. Joffe’s recommendation. She pointed to a “sharp drop” in measles, noting that new cases had fallen to single digits.
“Public health officials implemented targeted vaccination campaigns, expanded clinic hours and launched provincewide outreach,” Ms. McKee wrote in an email. “Since March, more than 130,000 measles vaccines have been administered across Alberta — a 50 percent increase compared to the same period last year.”
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The United States has battled measles outbreaks but retains its elimination status because outbreaks have not lasted a year.
“We’ve had a safe vaccine for measles for 60 years,” said Dr. Adam Ratner, a pediatric infectious disease specialist in New York who wrote a book on measles. “It’s not like when we were at the beginning of Covid and we didn’t have a vaccine, we didn’t have good tests and we were still learning the basics.”
Canada has reported two measles deaths this year. Measles can weaken the immune system for years, and can foretell the resurgence of other vaccine-preventable illnesses.
“Measles, polio, whooping cough — people forget about these diseases because we don’t have them anymore,” Dr. Joffe said. “But when you stop vaccinating, they come back.”
Rebecca R. Ruiz is an investigative reporter for The Times based in London.
Vjosa Isai is a reporter and researcher for The Times based in Toronto, where she covers news from across Canada.
